A topical combination product primarily used in the management of chronic, non-infectious dermatoses characterized by hyperkeratosis, scaling, and inflammation, such as psoriasis and seborrheic dermatitis. Coal Tar acts as an anti-inflammatory, antipruritic, and antimitotic agent, while Salicylic Acid provides keratolytic and mild anti-inflammatory effects. This combination is a cornerstone of topical therapy in the Indian market for its efficacy, cost-effectiveness, and long history of use.
Adult: Apply a thin layer to affected areas once or twice daily, typically at bedtime. For scalp: Apply, leave on for 5-10 minutes, then lather and rinse thoroughly. Frequency may be reduced to alternate days or 2-3 times per week for maintenance.
Note: 1. Wash and dry the affected area. 2. Apply a thin film and rub gently until absorbed. 3. Avoid contact with eyes, mucous membranes, genitalia, and face unless directed by a physician. 4. For scalp use, part hair and apply directly to scalp, not hair. 5. May be occluded with a bandage or shower cap for scalp to enhance efficacy, but this increases absorption and risk of irritation. 6. Wash hands thoroughly after application. 7. Can stain clothing and bedding; use old fabrics.
The combination works synergistically. Coal Tar reduces epidermal hyperproliferation and dermal inflammation seen in psoriasis and dermatitis. It suppresses DNA synthesis, reduces mitotic activity in the basal layer, and exhibits anti-itch properties. Salicylic Acid facilitates the penetration of coal tar by breaking down intercellular keratinocyte bonds (desmogleins) and dissolving the stratum corneum. It also has mild anti-inflammatory properties.
Pregnancy: Category C (US FDA). Animal studies are inadequate. Coal tar is a potential teratogen and mutagen. Salicylic acid is absorbed and related to aspirin. Use only if the potential benefit justifies the potential risk to the fetus. Avoid use on large areas, for prolonged periods, or under occlusion.
Driving: No effect on driving ability.
| Other Topical Salicylic Acid Preparations or Keratolytics (e.g., Urea, Lactic Acid) | Increased risk of excessive skin dryness, irritation, and systemic salicylate absorption. | Major |
| Topical Tretinoin, Benzoyl Peroxide, or other strong irritants | Additive skin irritation and inflammation. | Major |
| Photosensitizing Drugs (e.g., Tetracyclines, Fluoroquinolones, Thiazides, Phenothiazines) | Increased risk of severe phototoxic reactions. | Major |
| Oral Anticoagulants (e.g., Warfarin) | Systemically absorbed salicylic acid may potentiate anticoagulant effect and increase bleeding risk. | Moderate |
| Oral Hypoglycemics (e.g., Sulfonylureas) | Salicylates may potentiate hypoglycemic effect. | Moderate |
| Methotrexate | Theoretical risk of increased hepatotoxicity; caution advised. | Moderate |